Association of Preinjury Beta-Blocker Exposure With Brain Injury Biomarkers Following Traumatic Brain Injury

Area of Science:

• Neuroscience
• Clinical Medicine
• Pharmacology

Background:

• Traumatic brain injury (TBI) is a significant cause of mortality and morbidity.
• Beta-blockers are commonly prescribed medications with potential neuroprotective or detrimental effects in TBI.
• Understanding the impact of preinjury beta-blocker exposure on TBI outcomes is crucial for patient management.

Purpose of the Study:

• To investigate the association between preinjury beta-blocker use and early blood-based brain injury biomarkers following TBI.
• To evaluate the impact of preinjury beta-blocker exposure on clinical outcomes up to 6 months post-TBI.
• To stratify analyses by TBI severity.

Main Methods:

• Retrospective study of adults (≥40 years) from the TRACK-TBI study.
• Exposure defined as preinjury beta-blocker utilization.
• Primary outcome: Day 1 blood biomarker levels; Secondary outcomes: Day 3/5 biomarkers, hospital mortality, 6-month Glasgow Outcome Scale-Extended (GOSE).
• Inverse probability-weighted models used for association analysis.

Main Results:

• 1185 patients included; 101 used preinjury beta-blockers (BB+).
• BB+ patients were older and had higher rates of hypertension.
• No significant association found between preinjury beta-blocker use and Day 1 biomarker levels.
• A marginal association of lower 6-month GOSE scores was observed in the moderate/severe TBI group with preinjury beta-blocker use (P=0.049).

Conclusions:

• Preinjury beta-blocker exposure was not clearly associated with early brain injury biomarkers or most clinical outcomes in TBI patients.
• A marginal negative impact on long-term outcomes in moderate/severe TBI warrants further investigation.
• Larger cohort studies are recommended to validate these findings.